Join the Mosaic of Hands at the Community Children’s Museum It is easy to participate:

1.) Complete the form below

2) PRINT your message clearly below

3) Trace your hand(s) on the back of this or any other paper and put your name in the middle of the hand along with the size and color of glass you are purchasing.

4) Mail the form and the handprint with a check made out to the Community Children’s Museum to 77 East Blackwell Street, Dover, NJ 07801 (Fully tax deductible)

5) If you have any questions, please call the museum at 973 366-9060.

Name: ________________________________________________________

Address: ______________________________________________________

Phone #: ______________________________________________________

Email: ________________________________________________________

Circle the size and color you want:

Red
Yellow
Green Blue Purple
Orange

7” round (has room for one hand) Donation of $50

9” round (has room for two hands) Donation of $100

Please print clearly how you want your inscription to read (no more than 15 words please). Your gift is tax deductible to the fullest extent allowed by law. The museum reserves the right to review the wording of your message for content and appropriateness.

PRINT MESSAGE CLEARLY BELOW:

___________________________________________________________________________

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